|
HC CARBON DIOXIDE (BICARB)
|
Facility
|
IP
|
$21.64
|
|
|
Service Code
|
CPT 82374
|
| Hospital Charge Code |
30100133
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.63 |
| Max. Negotiated Rate |
$19.48 |
| Rate for Payer: Aetna Commercial |
$18.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.07
|
| Rate for Payer: Cash Price |
$17.31
|
| Rate for Payer: Cofinity Commercial |
$15.15
|
| Rate for Payer: Cofinity Commercial |
$18.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.31
|
| Rate for Payer: Healthscope Commercial |
$19.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.39
|
| Rate for Payer: PHP Commercial |
$18.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.07
|
| Rate for Payer: Priority Health SBD |
$13.63
|
|
|
HC CARBOXYHEMOGLOBIN
|
Facility
|
IP
|
$78.45
|
|
|
Service Code
|
CPT 82375
|
| Hospital Charge Code |
30100134
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.42 |
| Max. Negotiated Rate |
$70.61 |
| Rate for Payer: Aetna Commercial |
$66.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.99
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cofinity Commercial |
$54.91
|
| Rate for Payer: Cofinity Commercial |
$67.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$54.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.76
|
| Rate for Payer: Healthscope Commercial |
$70.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.68
|
| Rate for Payer: PHP Commercial |
$66.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.99
|
| Rate for Payer: Priority Health SBD |
$49.42
|
|
|
HC CARBOXYHEMOGLOBIN
|
Facility
|
OP
|
$78.45
|
|
|
Service Code
|
CPT 82375
|
| Hospital Charge Code |
30100134
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.60 |
| Max. Negotiated Rate |
$70.61 |
| Rate for Payer: Aetna Commercial |
$66.68
|
| Rate for Payer: Aetna Medicare |
$12.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.40
|
| Rate for Payer: BCBS Complete |
$6.93
|
| Rate for Payer: BCBS MAPPO |
$12.32
|
| Rate for Payer: BCN Medicare Advantage |
$12.32
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cofinity Commercial |
$67.47
|
| Rate for Payer: Cofinity Commercial |
$54.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$54.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.32
|
| Rate for Payer: Healthscope Commercial |
$70.61
|
| Rate for Payer: Mclaren Medicaid |
$6.60
|
| Rate for Payer: Mclaren Medicare |
$12.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.94
|
| Rate for Payer: Meridian Medicaid |
$6.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.68
|
| Rate for Payer: PACE Medicare |
$11.70
|
| Rate for Payer: PACE SWMI |
$12.32
|
| Rate for Payer: PHP Commercial |
$66.68
|
| Rate for Payer: PHP Medicare Advantage |
$12.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.99
|
| Rate for Payer: Priority Health Medicare |
$12.32
|
| Rate for Payer: Priority Health SBD |
$49.42
|
| Rate for Payer: Railroad Medicare Medicare |
$12.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.32
|
| Rate for Payer: UHC Medicare Advantage |
$12.32
|
| Rate for Payer: UHCCP Medicaid |
$6.94
|
| Rate for Payer: VA VA |
$12.32
|
|
|
HC CARDIAC REH OP PH 2 WO MONITOR
|
Facility
|
IP
|
$197.91
|
|
|
Service Code
|
CPT 93797
|
| Hospital Charge Code |
94300007
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$124.68 |
| Max. Negotiated Rate |
$178.12 |
| Rate for Payer: Aetna Commercial |
$168.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.64
|
| Rate for Payer: Cash Price |
$158.33
|
| Rate for Payer: Cofinity Commercial |
$138.54
|
| Rate for Payer: Cofinity Commercial |
$170.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$138.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.33
|
| Rate for Payer: Healthscope Commercial |
$178.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.22
|
| Rate for Payer: PHP Commercial |
$168.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.64
|
| Rate for Payer: Priority Health SBD |
$124.68
|
|
|
HC CARDIAC REH OP PH 2 WO MONITOR
|
Facility
|
OP
|
$197.91
|
|
|
Service Code
|
CPT 93797
|
| Hospital Charge Code |
94300007
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$65.82 |
| Max. Negotiated Rate |
$345.67 |
| Rate for Payer: Aetna Commercial |
$168.22
|
| Rate for Payer: Aetna Medicare |
$127.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$153.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$153.50
|
| Rate for Payer: BCBS Complete |
$69.11
|
| Rate for Payer: BCBS MAPPO |
$122.80
|
| Rate for Payer: BCN Medicare Advantage |
$122.80
|
| Rate for Payer: Cash Price |
$158.33
|
| Rate for Payer: Cash Price |
$158.33
|
| Rate for Payer: Cofinity Commercial |
$170.20
|
| Rate for Payer: Cofinity Commercial |
$138.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$138.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.80
|
| Rate for Payer: Healthscope Commercial |
$178.12
|
| Rate for Payer: Mclaren Medicaid |
$65.82
|
| Rate for Payer: Mclaren Medicare |
$122.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.94
|
| Rate for Payer: Meridian Medicaid |
$69.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$141.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.22
|
| Rate for Payer: PACE Medicare |
$116.66
|
| Rate for Payer: PACE SWMI |
$122.80
|
| Rate for Payer: PHP Commercial |
$168.22
|
| Rate for Payer: PHP Medicare Advantage |
$122.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.64
|
| Rate for Payer: Priority Health Medicare |
$122.80
|
| Rate for Payer: Priority Health SBD |
$124.68
|
| Rate for Payer: Railroad Medicare Medicare |
$122.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$345.67
|
| Rate for Payer: UHC Core |
$146.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$122.80
|
| Rate for Payer: UHC Exchange |
$146.45
|
| Rate for Payer: UHC Medicare Advantage |
$122.80
|
| Rate for Payer: UHCCP Medicaid |
$69.14
|
| Rate for Payer: VA VA |
$122.80
|
|
|
HC CARDIOLIPIN AB IGA
|
Facility
|
OP
|
$51.17
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200146
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.64 |
| Max. Negotiated Rate |
$71.64 |
| Rate for Payer: Aetna Commercial |
$43.49
|
| Rate for Payer: Aetna Medicare |
$26.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.81
|
| Rate for Payer: BCBS Complete |
$14.32
|
| Rate for Payer: BCBS MAPPO |
$25.45
|
| Rate for Payer: BCN Medicare Advantage |
$25.45
|
| Rate for Payer: Cash Price |
$40.94
|
| Rate for Payer: Cash Price |
$40.94
|
| Rate for Payer: Cofinity Commercial |
$44.01
|
| Rate for Payer: Cofinity Commercial |
$35.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$35.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.45
|
| Rate for Payer: Healthscope Commercial |
$46.05
|
| Rate for Payer: Mclaren Medicaid |
$13.64
|
| Rate for Payer: Mclaren Medicare |
$25.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.72
|
| Rate for Payer: Meridian Medicaid |
$14.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.49
|
| Rate for Payer: PACE Medicare |
$24.18
|
| Rate for Payer: PACE SWMI |
$25.45
|
| Rate for Payer: PHP Commercial |
$43.49
|
| Rate for Payer: PHP Medicare Advantage |
$25.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.26
|
| Rate for Payer: Priority Health Medicare |
$25.45
|
| Rate for Payer: Priority Health SBD |
$32.24
|
| Rate for Payer: Railroad Medicare Medicare |
$25.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.45
|
| Rate for Payer: UHC Medicare Advantage |
$25.45
|
| Rate for Payer: UHCCP Medicaid |
$14.33
|
| Rate for Payer: VA VA |
$25.45
|
|
|
HC CARDIOLIPIN AB IGA
|
Facility
|
IP
|
$51.17
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200146
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$32.24 |
| Max. Negotiated Rate |
$46.05 |
| Rate for Payer: Aetna Commercial |
$43.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.26
|
| Rate for Payer: Cash Price |
$40.94
|
| Rate for Payer: Cofinity Commercial |
$35.82
|
| Rate for Payer: Cofinity Commercial |
$44.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$35.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.94
|
| Rate for Payer: Healthscope Commercial |
$46.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.49
|
| Rate for Payer: PHP Commercial |
$43.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.26
|
| Rate for Payer: Priority Health SBD |
$32.24
|
|
|
HC CARDIOLIPIN AB IGG
|
Facility
|
OP
|
$51.17
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200144
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.64 |
| Max. Negotiated Rate |
$71.64 |
| Rate for Payer: Aetna Commercial |
$43.49
|
| Rate for Payer: Aetna Medicare |
$26.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.81
|
| Rate for Payer: BCBS Complete |
$14.32
|
| Rate for Payer: BCBS MAPPO |
$25.45
|
| Rate for Payer: BCN Medicare Advantage |
$25.45
|
| Rate for Payer: Cash Price |
$40.94
|
| Rate for Payer: Cash Price |
$40.94
|
| Rate for Payer: Cofinity Commercial |
$44.01
|
| Rate for Payer: Cofinity Commercial |
$35.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$35.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.45
|
| Rate for Payer: Healthscope Commercial |
$46.05
|
| Rate for Payer: Mclaren Medicaid |
$13.64
|
| Rate for Payer: Mclaren Medicare |
$25.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.72
|
| Rate for Payer: Meridian Medicaid |
$14.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.49
|
| Rate for Payer: PACE Medicare |
$24.18
|
| Rate for Payer: PACE SWMI |
$25.45
|
| Rate for Payer: PHP Commercial |
$43.49
|
| Rate for Payer: PHP Medicare Advantage |
$25.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.26
|
| Rate for Payer: Priority Health Medicare |
$25.45
|
| Rate for Payer: Priority Health SBD |
$32.24
|
| Rate for Payer: Railroad Medicare Medicare |
$25.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.45
|
| Rate for Payer: UHC Medicare Advantage |
$25.45
|
| Rate for Payer: UHCCP Medicaid |
$14.33
|
| Rate for Payer: VA VA |
$25.45
|
|
|
HC CARDIOLIPIN AB IGG
|
Facility
|
IP
|
$51.17
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200144
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$32.24 |
| Max. Negotiated Rate |
$46.05 |
| Rate for Payer: Aetna Commercial |
$43.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.26
|
| Rate for Payer: Cash Price |
$40.94
|
| Rate for Payer: Cofinity Commercial |
$35.82
|
| Rate for Payer: Cofinity Commercial |
$44.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$35.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.94
|
| Rate for Payer: Healthscope Commercial |
$46.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.49
|
| Rate for Payer: PHP Commercial |
$43.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.26
|
| Rate for Payer: Priority Health SBD |
$32.24
|
|
|
HC CARDIOLIPIN AB IGM
|
Facility
|
IP
|
$51.17
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200145
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$32.24 |
| Max. Negotiated Rate |
$46.05 |
| Rate for Payer: Aetna Commercial |
$43.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.26
|
| Rate for Payer: Cash Price |
$40.94
|
| Rate for Payer: Cofinity Commercial |
$35.82
|
| Rate for Payer: Cofinity Commercial |
$44.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$35.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.94
|
| Rate for Payer: Healthscope Commercial |
$46.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.49
|
| Rate for Payer: PHP Commercial |
$43.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.26
|
| Rate for Payer: Priority Health SBD |
$32.24
|
|
|
HC CARDIOLIPIN AB IGM
|
Facility
|
OP
|
$51.17
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200145
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.64 |
| Max. Negotiated Rate |
$71.64 |
| Rate for Payer: Aetna Commercial |
$43.49
|
| Rate for Payer: Aetna Medicare |
$26.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.81
|
| Rate for Payer: BCBS Complete |
$14.32
|
| Rate for Payer: BCBS MAPPO |
$25.45
|
| Rate for Payer: BCN Medicare Advantage |
$25.45
|
| Rate for Payer: Cash Price |
$40.94
|
| Rate for Payer: Cash Price |
$40.94
|
| Rate for Payer: Cofinity Commercial |
$44.01
|
| Rate for Payer: Cofinity Commercial |
$35.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$35.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.45
|
| Rate for Payer: Healthscope Commercial |
$46.05
|
| Rate for Payer: Mclaren Medicaid |
$13.64
|
| Rate for Payer: Mclaren Medicare |
$25.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.72
|
| Rate for Payer: Meridian Medicaid |
$14.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.49
|
| Rate for Payer: PACE Medicare |
$24.18
|
| Rate for Payer: PACE SWMI |
$25.45
|
| Rate for Payer: PHP Commercial |
$43.49
|
| Rate for Payer: PHP Medicare Advantage |
$25.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.26
|
| Rate for Payer: Priority Health Medicare |
$25.45
|
| Rate for Payer: Priority Health SBD |
$32.24
|
| Rate for Payer: Railroad Medicare Medicare |
$25.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.45
|
| Rate for Payer: UHC Medicare Advantage |
$25.45
|
| Rate for Payer: UHCCP Medicaid |
$14.33
|
| Rate for Payer: VA VA |
$25.45
|
|
|
HC CARDIOLITE/MIRALUMA STUDY
|
Facility
|
OP
|
$515.54
|
|
|
Service Code
|
HCPCS A9500
|
| Hospital Charge Code |
34300001
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$206.22 |
| Max. Negotiated Rate |
$463.99 |
| Rate for Payer: Aetna Commercial |
$438.21
|
| Rate for Payer: Aetna Medicare |
$257.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$335.10
|
| Rate for Payer: BCBS Complete |
$206.22
|
| Rate for Payer: Cash Price |
$412.43
|
| Rate for Payer: Cofinity Commercial |
$360.88
|
| Rate for Payer: Cofinity Commercial |
$443.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$360.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$412.43
|
| Rate for Payer: Healthscope Commercial |
$463.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$438.21
|
| Rate for Payer: PHP Commercial |
$438.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$335.10
|
| Rate for Payer: Priority Health SBD |
$324.79
|
|
|
HC CARDIOLITE/MIRALUMA STUDY
|
Facility
|
IP
|
$515.54
|
|
|
Service Code
|
HCPCS A9500
|
| Hospital Charge Code |
34300001
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$324.79 |
| Max. Negotiated Rate |
$463.99 |
| Rate for Payer: Aetna Commercial |
$438.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$335.10
|
| Rate for Payer: Cash Price |
$412.43
|
| Rate for Payer: Cofinity Commercial |
$360.88
|
| Rate for Payer: Cofinity Commercial |
$443.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$360.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$412.43
|
| Rate for Payer: Healthscope Commercial |
$463.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$438.21
|
| Rate for Payer: PHP Commercial |
$438.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$335.10
|
| Rate for Payer: Priority Health SBD |
$324.79
|
|
|
HC CARDIOPULMONARY EX TEST
|
Facility
|
IP
|
$1,122.69
|
|
|
Service Code
|
CPT 94621
|
| Hospital Charge Code |
46000007
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$707.29 |
| Max. Negotiated Rate |
$1,010.42 |
| Rate for Payer: Aetna Commercial |
$954.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$729.75
|
| Rate for Payer: Cash Price |
$898.15
|
| Rate for Payer: Cofinity Commercial |
$785.88
|
| Rate for Payer: Cofinity Commercial |
$965.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$785.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$898.15
|
| Rate for Payer: Healthscope Commercial |
$1,010.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$954.29
|
| Rate for Payer: PHP Commercial |
$954.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$729.75
|
| Rate for Payer: Priority Health SBD |
$707.29
|
|
|
HC CARDIOPULMONARY EX TEST
|
Facility
|
OP
|
$1,122.69
|
|
|
Service Code
|
CPT 94621
|
| Hospital Charge Code |
46000007
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$162.78 |
| Max. Negotiated Rate |
$1,010.42 |
| Rate for Payer: Aetna Commercial |
$954.29
|
| Rate for Payer: Aetna Medicare |
$315.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$729.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.62
|
| Rate for Payer: BCBS Complete |
$170.92
|
| Rate for Payer: BCBS MAPPO |
$303.70
|
| Rate for Payer: BCN Medicare Advantage |
$303.70
|
| Rate for Payer: Cash Price |
$898.15
|
| Rate for Payer: Cash Price |
$898.15
|
| Rate for Payer: Cofinity Commercial |
$965.51
|
| Rate for Payer: Cofinity Commercial |
$785.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$785.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$898.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.70
|
| Rate for Payer: Healthscope Commercial |
$1,010.42
|
| Rate for Payer: Mclaren Medicaid |
$162.78
|
| Rate for Payer: Mclaren Medicare |
$303.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.88
|
| Rate for Payer: Meridian Medicaid |
$170.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$954.29
|
| Rate for Payer: PACE Medicare |
$288.51
|
| Rate for Payer: PACE SWMI |
$303.70
|
| Rate for Payer: PHP Commercial |
$954.29
|
| Rate for Payer: PHP Medicare Advantage |
$303.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$729.75
|
| Rate for Payer: Priority Health Medicare |
$303.70
|
| Rate for Payer: Priority Health SBD |
$707.29
|
| Rate for Payer: Railroad Medicare Medicare |
$303.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$854.89
|
| Rate for Payer: UHC Core |
$830.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$303.70
|
| Rate for Payer: UHC Exchange |
$830.79
|
| Rate for Payer: UHC Medicare Advantage |
$303.70
|
| Rate for Payer: UHCCP Medicaid |
$170.98
|
| Rate for Payer: VA VA |
$303.70
|
|
|
HC CARDIOVERSION
|
Facility
|
IP
|
$1,197.85
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
48000002
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$754.65 |
| Max. Negotiated Rate |
$1,078.07 |
| Rate for Payer: Aetna Commercial |
$1,018.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$778.60
|
| Rate for Payer: Cash Price |
$958.28
|
| Rate for Payer: Cofinity Commercial |
$1,030.15
|
| Rate for Payer: Cofinity Commercial |
$838.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$838.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$958.28
|
| Rate for Payer: Healthscope Commercial |
$1,078.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,018.17
|
| Rate for Payer: PHP Commercial |
$1,018.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$778.60
|
| Rate for Payer: Priority Health SBD |
$754.65
|
|
|
HC CARDIOVERSION
|
Facility
|
OP
|
$1,197.85
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
48000002
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$342.08 |
| Max. Negotiated Rate |
$1,796.47 |
| Rate for Payer: Aetna Commercial |
$1,018.17
|
| Rate for Payer: Aetna Medicare |
$663.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$778.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$797.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$797.75
|
| Rate for Payer: BCBS Complete |
$359.18
|
| Rate for Payer: BCBS MAPPO |
$638.20
|
| Rate for Payer: BCN Medicare Advantage |
$638.20
|
| Rate for Payer: Cash Price |
$958.28
|
| Rate for Payer: Cash Price |
$958.28
|
| Rate for Payer: Cofinity Commercial |
$838.50
|
| Rate for Payer: Cofinity Commercial |
$1,030.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$838.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$958.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$638.20
|
| Rate for Payer: Healthscope Commercial |
$1,078.07
|
| Rate for Payer: Mclaren Medicaid |
$342.08
|
| Rate for Payer: Mclaren Medicare |
$638.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$670.11
|
| Rate for Payer: Meridian Medicaid |
$359.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$733.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,018.17
|
| Rate for Payer: PACE Medicare |
$606.29
|
| Rate for Payer: PACE SWMI |
$638.20
|
| Rate for Payer: PHP Commercial |
$1,018.17
|
| Rate for Payer: PHP Medicare Advantage |
$638.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$778.60
|
| Rate for Payer: Priority Health Medicare |
$638.20
|
| Rate for Payer: Priority Health SBD |
$754.65
|
| Rate for Payer: Railroad Medicare Medicare |
$638.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,796.47
|
| Rate for Payer: UHC Core |
$886.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$638.20
|
| Rate for Payer: UHC Exchange |
$886.41
|
| Rate for Payer: UHC Medicare Advantage |
$638.20
|
| Rate for Payer: UHCCP Medicaid |
$359.31
|
| Rate for Payer: VA VA |
$638.20
|
|
|
HC CARDIOVERSION EXT
|
Facility
|
OP
|
$998.20
|
|
| Hospital Charge Code |
45000034
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$399.28 |
| Max. Negotiated Rate |
$898.38 |
| Rate for Payer: Aetna Commercial |
$848.47
|
| Rate for Payer: Aetna Medicare |
$499.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$648.83
|
| Rate for Payer: BCBS Complete |
$399.28
|
| Rate for Payer: Cash Price |
$798.56
|
| Rate for Payer: Cofinity Commercial |
$698.74
|
| Rate for Payer: Cofinity Commercial |
$858.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$698.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$798.56
|
| Rate for Payer: Healthscope Commercial |
$898.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$848.47
|
| Rate for Payer: PHP Commercial |
$848.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$648.83
|
| Rate for Payer: Priority Health SBD |
$628.87
|
|
|
HC CARDIOVERSION EXT
|
Facility
|
IP
|
$998.20
|
|
| Hospital Charge Code |
45000034
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$628.87 |
| Max. Negotiated Rate |
$898.38 |
| Rate for Payer: Aetna Commercial |
$848.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$648.83
|
| Rate for Payer: Cash Price |
$798.56
|
| Rate for Payer: Cofinity Commercial |
$698.74
|
| Rate for Payer: Cofinity Commercial |
$858.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$698.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$798.56
|
| Rate for Payer: Healthscope Commercial |
$898.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$848.47
|
| Rate for Payer: PHP Commercial |
$848.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$648.83
|
| Rate for Payer: Priority Health SBD |
$628.87
|
|
|
HC CAREGIVER HEALTH RISK ASSMT
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 96161
|
| Hospital Charge Code |
51000095
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$15.57 |
| Max. Negotiated Rate |
$81.77 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$30.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.31
|
| Rate for Payer: BCBS Complete |
$16.35
|
| Rate for Payer: BCBS MAPPO |
$29.05
|
| Rate for Payer: BCN Medicare Advantage |
$29.05
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.05
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Mclaren Medicaid |
$15.57
|
| Rate for Payer: Mclaren Medicare |
$29.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.50
|
| Rate for Payer: Meridian Medicaid |
$16.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: PACE Medicare |
$27.60
|
| Rate for Payer: PACE SWMI |
$29.05
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$29.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.49
|
| Rate for Payer: Priority Health Medicare |
$29.05
|
| Rate for Payer: Priority Health SBD |
$33.43
|
| Rate for Payer: Railroad Medicare Medicare |
$29.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.05
|
| Rate for Payer: UHC Medicare Advantage |
$29.05
|
| Rate for Payer: UHCCP Medicaid |
$16.36
|
| Rate for Payer: VA VA |
$29.05
|
|
|
HC CAREGIVER HEALTH RISK ASSMT
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 96161
|
| Hospital Charge Code |
51000095
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$33.43 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.49
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.49
|
| Rate for Payer: Priority Health SBD |
$33.43
|
|
|
HC CAREGIVER TRAINING 1ST 30 MIN
|
Facility
|
OP
|
$129.54
|
|
|
Service Code
|
CPT 97550
|
| Hospital Charge Code |
42000065
|
| Min. Negotiated Rate |
$51.82 |
| Max. Negotiated Rate |
$116.59 |
| Rate for Payer: Aetna Commercial |
$110.11
|
| Rate for Payer: Aetna Medicare |
$64.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.20
|
| Rate for Payer: BCBS Complete |
$51.82
|
| Rate for Payer: Cash Price |
$103.63
|
| Rate for Payer: Cofinity Commercial |
$111.40
|
| Rate for Payer: Cofinity Commercial |
$90.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$90.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.63
|
| Rate for Payer: Healthscope Commercial |
$116.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.11
|
| Rate for Payer: PHP Commercial |
$110.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.20
|
| Rate for Payer: Priority Health SBD |
$81.61
|
|
|
HC CAREGIVER TRAINING 1ST 30 MIN
|
Facility
|
IP
|
$129.54
|
|
|
Service Code
|
CPT 97550
|
| Hospital Charge Code |
42000065
|
| Min. Negotiated Rate |
$81.61 |
| Max. Negotiated Rate |
$116.59 |
| Rate for Payer: Aetna Commercial |
$110.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.20
|
| Rate for Payer: Cash Price |
$103.63
|
| Rate for Payer: Cofinity Commercial |
$111.40
|
| Rate for Payer: Cofinity Commercial |
$90.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$90.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.63
|
| Rate for Payer: Healthscope Commercial |
$116.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.11
|
| Rate for Payer: PHP Commercial |
$110.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.20
|
| Rate for Payer: Priority Health SBD |
$81.61
|
|
|
HC CAREGIVER TRAINING EA ADDL 15 MIN
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 97551
|
| Hospital Charge Code |
42000066
|
| Min. Negotiated Rate |
$24.48 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna Medicare |
$30.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.78
|
| Rate for Payer: BCBS Complete |
$24.48
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$42.84
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$42.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.02
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.78
|
| Rate for Payer: Priority Health SBD |
$38.56
|
|
|
HC CAREGIVER TRAINING EA ADDL 15 MIN
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 97551
|
| Hospital Charge Code |
42000066
|
| Min. Negotiated Rate |
$38.56 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.78
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$42.84
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$42.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.02
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.78
|
| Rate for Payer: Priority Health SBD |
$38.56
|
|
